Accelerating Implementation of Virtual Care in an Integrated Health Care System: Future Research and Operations Priorities
Accelerating Implementation of Virtual Care in an Integrated Health Care System: Future Research and Operations Priorities
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DOI：
10.1007/s11606-020-06517-3
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发表时间：
2021-01-26
影响因子：
5.7
通讯作者：
Bosworth, Hayden B.
中科院分区：
文献类型：
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作者：
Lewinski, Allison A.;Sullivan, Caitlin;Bosworth, Hayden B.
背景虚拟护理对退伍军人健康管理局（VHA）扩大退伍军人获得护理的努力至关重要。卫生保健政策，如退伍军人准入，选择和责任（选择）法和维护内部系统和加强综合外部网络（使命）法影响VHA如何提供护理。需要研究改进虚拟护理提供模式的方法，以满足退伍军人，临床医生和VHA利益相关者的需求。鉴于虚拟方法对于增加获得高质量VHA护理的重要性，2019年12月，我们召集了一个智囊团，加速在VHA实践中实施虚拟护理，以考虑整个VHA虚拟护理研究和实践的挑战，讨论使用和评估虚拟护理的新方法，评估虚拟护理的前景，并制定优先事项，以加强VHA中的虚拟护理。方法：我们采用参与式的方法来开发潜在的虚拟护理研究和活动在VHA的优先事项。我们通过部队排序和小组讨论来完善这些优先事项，并为选定的优先事项制定解决方案。智囊团与会者（n = 18）由VHA利益相关者组成，包括运营合作伙伴（例如，农村卫生办公室、护理服务办公室、卫生服务研究与发展）、临床医生（例如，医生、护士、心理学家、医师助理）和卫生服务研究人员。我们初步确定了15个潜在的优先事项，并将其缩小到4个。这四个优先事项是（1）扩展循证实践，（2）集中虚拟护理，（3）在VHA内通过虚拟护理创建高价值护理，以及（4）为虚拟护理确定合适的患者。结论我们的智囊团在制定合作研究议程以优化VHA内虚拟护理的使用方面迈出了重要的一步。我们将研究和运营利益相关者聚集在一起，并确定了虚拟护理的可能性、合作伙伴关系和潜在解决方案。
Background Virtual care is critical to Veterans Health Administration (VHA) efforts to expand veterans' access to care. Health care policies such as the Veterans Access, Choice, and Accountability (CHOICE) Act and the Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act impact how the VHA provides care. Research on ways to refine virtual care delivery models to meet the needs of veterans, clinicians, and VHA stakeholders is needed. Objective Given the importance of virtual approaches for increasing access to high-quality VHA care, in December 2019, we convened a Think Tank, Accelerating Implementation of Virtual Care in VHA Practice, to consider challenges to virtual care research and practice across the VHA, discuss novel approaches to using and evaluating virtual care, assess perspectives on virtual care, and develop priorities to enhance virtual care in the VHA. Methods We used a participatory approach to develop potential priorities for virtual care research and activities at the VHA. We refined these priorities through force-ranked prioritization and group discussion, and developed solutions for selected priorities. Results Think Tank attendees (n = 18) consisted of VHA stakeholders, including operations partners (e.g., Office of Rural Health, Office of Nursing Services, Health Services Research and Development), clinicians (e.g., physicians, nurses, psychologists, physician assistants), and health services researchers. We identified an initial list of fifteen potential priorities and narrowed these down to four. The four priorities were (1) scaling evidence-based practices, (2) centralizing virtual care, (3) creating high-value care within the VHA with virtual care, and (4) identifying appropriate patients for virtual care. Conclusion Our Think Tank took an important step in setting a partnered research agenda to optimize the use of virtual care within the VHA. We brought together research and operations stakeholders and identified possibilities, partnerships, and potential solutions for virtual care.